Hemodynamic Simulation of Coronary Microcirculation using Ferumoxytol-Enhanced MRI Fractional Myocardial Blood Volume Maps

Motivation: Coronary microvascular hemodynamics is vital in ischemic heart disease. Goal(s): To provide an in silico framework for modeling subject-specific coronary microvascular networks, offering reliable hemodynamic measurements from ferumoxytol-enhanced MRI fractional myocardial blood volume (FE-MRI fMBV) maps. Approach: FE-MRI fMBV maps were integrated with an adaptive, muti-stage, 1D arterial network generation algorithm, enabling reproducible hemodynamic simulations in subject-specific myocardium. Results: The synthetic networks showed strong correlation with clinical data (r >0.99) and minimal variability in flow rates and resistance across vessel seeds; whereas, hemodynamic simulations display consistent blood flow and resistance values, supporting its potential application in coronary microvascular disease. Impact: The proposed framework facilitates non-invasive, patient-specific hemodynamic modeling that is critical to the diagnosis and management of ischemic heart disease (IHD). Its reproducibility, accuracy, and potential adaptability provide a foundation for MRI-based in silico diagnostics to transform personalized cardiovascular care.